35-149 10. Do any signs exist on the property? YES NO
IF YES,describe size,type and location:
Are there any proposed changes to or additions of signs intended for the property?YES NO_�
IF YES,describe size,type and location:
11. ALL INFORMATION MAST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO
LACK OF INFORMATION.
This c01— to Be P111ed in
by the Building Department
Required
Existing Proposed By Zoning
Lot size
3
Frontage
Setbacks - c
- side L: R: L: R:
- rear
Building height
Bldg Square footage
%Open Space:
(Lot area minus bldg /O
&paved parking) l
of -Parking Spaces
# %f Loading Docks
Fill:
'Av.oi-time--& location)
13 . Certification: I hereby certify that the information contained herein
�f is true and accurate to the best of my knowledge.
DAVE: 11,-Z/7 S'" APPLICANT's SIGNATURE �G
NOTE: tauuanoe of a zoning permit does not relieve an r plioant's bur en to comply with all
zoning requirements and obtain ell required permits T m the Board of Health, Conservation .
Commission, Department of Publio Works and other epplioable permit granting authorities.
'.`,; FILE if
r�
t
U iU
-7 r
File No.
ZONING PERMIT APPLICATION ff . 1' ` ';''
PLEASE TYPE OR PRINT ALL SNFORMATION
1. Name of Applicant: I (I A/ /_
Address: (,V l-A �,c/( 1) Y - Telephone: q/3 - 5� "G
2. OwnerofProperty: t- 0";Vk l 'ti�ar2,=TTi=
Address: Telephone:
3. Status of Applicant: Owner Contract Purchaser Lessee
Other(explain):
4. Street Address: L
Parcel Id: Zoning Map# J� Parcel# 7 District(s):
(TO BE FILLED IN BY THE BUILDIN DEPARTMENT)
5. Existing Use of Structure/Property W 0'0A/=1) /'� t
6. Description of Proposed UseNVork/Project/Occupation: (Use additional sheets if necessary):
/3 ,'4, , -t
v
7. Attached Plans: Sketch Plan Site Plan Engineered/Surveyed Plans
Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Department Files.
8. Has a Special Permit/Vadance/Finding ever been issued for/on the site?
I
NO__,,--' DON'T KNOW YES IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document#
9. Does the site contain a brook,body of water or wetlands? NO_Z--' DON'T KNOW YES
IF YES,has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained ,date issued:
(FORM CONTINUES ON OTHER SIDE)
r)
FILE FILE #
APPLICANT/CONTACT PERSON:
ADDRESS/PHONE:
PROPERTY LOCATION:
MAP� �'`�_ PARCEL: ZONE
THIS SECTION FOMFFICIA.L USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED,REQUIRED DATE
7X)NTNG FORM 'T RI) OUT
Fee PAid
Fee PAid
Additinn to Existing
3 Sets of Plans / Pint Plan
a f-
f� S
THE FOLLOWING ACTION HAS BEEN TARN ON THIS APPLICATION'
Approved as presented/based on information presented
,//Denied as presented:
,4�special Permit and/or Site Plan Required under: § Z
PLANNING BOARD ZONING BOARD
Received& Recorded at Registry of Deeds Proof Enclosed
Finding Required under:§ w/ZONING BOARD OF APPEALS
Received& Recorded at Registry of Deeds Proof Enclosed
I
Variance Required under: § w/ZONING BOARD OF APPEALS
Received& Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
Permit from Co at' n ission
Signature of Building Inspector bate
NOTE_lssuanoe of a zoning permit does not relieve an npplionnts burden to comply with all
zoning reyuirerments and obtain all required permits from the Board of Health, Conservation
Commisslon, Department of Public Works and other applicable permit granting authoritles.